Saturday, February 13, 2016

Heberden's nodes deserve more respect.

Heberden’s nodes are hard or bony swellings that can develop in the distal interphalangeal joints (DIP) … They are a sign of osteoarthritis and are caused by formation of osteophytes (calcific spurs) of the articular (joint) cartilage in response to repeated trauma at the joint.

Heberden's nodes typically develop in middle age, beginning either with a chronic swelling of the affected joints or the sudden painful onset of redness, numbness, and loss of manual dexterity. This initial inflammation and pain eventually subsides, and the patient is left with a permanent bony outgrowth that often skews the fingertip sideways.

Heberden's nodes are more common in women than in men, and there seems to be a genetic component involved in predisposition to the condition.

Here’s another: “calcific spurs”. So why are they “nodes” and not spikes? Why are they rounded, like things that grow from an internal nexus? Why do they grow so quickly? Why don’t they keep growing? Why don’t we call these “Herberden’s tumors”? Why are they universal by age 80?

Lastly, how do they grow so quickly? I’ve seen the become prominent in 2-3 weeks. That’s tumor class growth.

Heberden’s Nodes: The Incidence of Hypertrophic Arthritis of the Fingers — NEJM1940 “They syndrome derives its name from Heberden, who first described it in 1902 as “digitorum nod”: “… little hard knobs, about the size of a small pea .. hardly ever attended with pain”. Charcot “Usually the onset is very obscure; however, there are attacks of redness, heat and temporary swelling of the soft parts”… “often accompanied by asthma, migraine, neuralgia and muscular rheumatism … commonly seen in patients with cancer of the breast”.

That 1940 article is fascinating, I’ll have to see if I can get the full article. We certainly don’t think of them as associated with breast cancer today.

I’d like to toss a few nodes in a blender and mine the slurry for non-human DNA.